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Prediction of Therapeutic Response of Apatinib in Recurrent Gliomas

5. februar 2021 opdateret af: Zhenyu Zhang, The First Affiliated Hospital of Zhengzhou University

MR and Histopathology Images Based Prediction of Therapeutic Response of Apatinib in Recurrent Gliomas Using Artificial Intelligence

Apatinib, also known as YN968D1, is a small-molecule tyrosine kinase inhibitor (TKI) that selectively binds to and inhibits vascular endothelial growth factor receptor 2 (VEGFR-2). This study aims to collect clinical, radiological and histopathology imaging including detailed radiological data, survival data, clinical parameters, molecular pathology and images of HE slices in patients with recurrent gliomas whose are treated with Apatinib, for evaluating the efficacy and safety of Apatinib. Moreover, by leveraging artificial intelligence, this study seeks to construct and refine MR and histopathology imaging based algorithms that are able to predict the responses to Apatinib of patients with recurrent gliomas.

Studieoversigt

Status

Rekruttering

Betingelser

Intervention / Behandling

Detaljeret beskrivelse

Effective treatment for recurrent gliomas is still challenging. Malignant gliomas are considered to be one of the most angiogenic cancers and are mostly sustained by vascular endothelial growth factor (VEGF) signaling via its endothelial tyrosine kinase receptor VEGF receptor 2 (VEGFR-2). Apatinib, also known as YN968D1, is a small-molecule tyrosine kinase inhibitor (TKI) that selectively binds to and inhibits VEGFR-2. Apatinib has been demonstrated as monotherapy that prolongs OS in patients with gastric cancers after two or more lines of chemotherapy with moderate, reversible, and easily managed adverse effects. This study aims to collect clinical, radiological and histopathology imaging including detailed radiological data, survival data, clinical parameters, molecular pathology and images of HE slices in patients with recurrent gliomas whose are treated with Apatinib, for evaluating the efficacy and safety of Apatinib. Moreover, by leveraging artificial intelligence, this study also seeks to construct and refine MR and histopathology imaging based algorithms that are able to predict the responses to Apatinib of patients with recurrent gliomas. The creation of a registry for patients with recurrent gliomas treated by Apatinib with detailed survival data, radiological data, histopathology image data and with sufficient sample size for artificial intelligence provides opportunities for personalized prediction of responses to Apatinib.

Undersøgelsestype

Observationel

Tilmelding (Forventet)

600

Kontakter og lokationer

Dette afsnit indeholder kontaktoplysninger for dem, der udfører undersøgelsen, og oplysninger om, hvor denne undersøgelse udføres.

Studiekontakt

Studiesteder

    • Henan
      • Zhengzhou, Henan, Kina, 450052
        • Rekruttering
        • Department of Neurosurgery, First Affiliated Hospital of Zhengzhou University
        • Kontakt:

Deltagelseskriterier

Forskere leder efter personer, der passer til en bestemt beskrivelse, kaldet berettigelseskriterier. Nogle eksempler på disse kriterier er en persons generelle helbredstilstand eller tidligere behandlinger.

Berettigelseskriterier

Aldre berettiget til at studere

18 år til 90 år (Voksen, Ældre voksen)

Tager imod sunde frivillige

Ingen

Køn, der er berettiget til at studere

Alle

Prøveudtagningsmetode

Sandsynlighedsprøve

Studiebefolkning

Subjects are all received anti-angiogenesis drug (Apatinib) in the First Affiliated Hospital of Zhengzhou University.

Beskrivelse

Inclusion Criteria:

  1. Adult patients with histologically-confirmed WHO Grade II-IV gliomas which have recurrent or progressive conditions.
  2. With measurable or evaluable disease defined by RANO criteria by MRI scan.
  3. Eastern Cooperative Oncology Group Performance Status (ECOG P.S.) of ≤ 2
  4. Life expectancy ≥3 months.
  5. No evidence of serious cardiopulmonary function damage, postoperative complication and hemorrhage on the baseline.
  6. No history of serious hypertension disease.
  7. Patients have adequate organ function as defined by the following criteria:

    • Hemoglobin (HGB) ≥90g/L
    • Absolute neutrophil count (ANC) ≥1.5×109/L
    • White blood cell (WBC) ≥3.0×109/L
    • Platelet count ≥80×109/L
    • Alanine aminotransferase(ALT) and Aspartate aminotransferase (AST) of ≤2.5 upper normal limitation (UNL) or ≤5 UNL in case of liver metastasis
    • Creatinine (Cr) of ≤1.25 UNL or creatinine clearance(Ccr) > 45 ml/min.
  8. With written informed consent signed voluntarily by patients themselves.

Exclusion Criteria:

  1. Patients with age<18 or >90 years.
  2. Pregnant or lactating women.
  3. Inadequately controlled hypertension (defined as systolic blood pressure > 140 and/or diastolic blood pressure > 90 mmHg on antihypertensive medications).
  4. New York Heart Association (NYHA) Grade II or greater congestive heart failure.
  5. Factors that could have an effect on oral medication.
  6. Abnormal Coagulation (international normalized ratio>1.5, prothrombin time>UNL+4s,activated partial thromboplastin time>1.5 UNL), with tendency of bleeding.
  7. Currently receive thrombolytic and anticoagulation therapy
  8. History of pneumorrhagia(CTCAE grade ≥2 ) or other parts hemorrhage(CTCAE grade ≥3 ) within 4 weeks prior to treatment.
  9. History of artery thrombosis and phlebothrombosis, such as cerebrovascular accident (including transient ischemic attack), deep venous thrombosis and pulmonary embolism, within 6 month prior to treatment.
  10. Medical history of clinically significant thrombosis (bleeding or clotting disorder), excluding warfarin(1mg po qd) and aspirin(80-100mg po qd) for prevention under INR≤1.5.

Studieplan

Dette afsnit indeholder detaljer om studieplanen, herunder hvordan undersøgelsen er designet, og hvad undersøgelsen måler.

Hvordan er undersøgelsen tilrettelagt?

Design detaljer

Kohorter og interventioner

Gruppe / kohorte
Intervention / Behandling
Apatinib
Apatinib 0.5g orally daily until the untolerable toxicities, disease progression or death
Apatinib 0.5g orally daily until the untolerable toxicities, disease progression or death

Hvad måler undersøgelsen?

Primære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Changes of Response to Treatment
Tidsramme: From enrollment to progression of disease. Estimated about 6 months
Response were evaluated with Response Assessment in Neuro-Oncology (RANO) criteria every 1 month after treament.
From enrollment to progression of disease. Estimated about 6 months

Sekundære resultatmål

Resultatmål
Foranstaltningsbeskrivelse
Tidsramme
Progression-Free Survival (PFS)
Tidsramme: From enrollment to progression of disease. Estimated about 6 months.
The length of time from enrollment until the time of progression of disease (PFS, progression-free survival)
From enrollment to progression of disease. Estimated about 6 months.
Overall Survival (OS)
Tidsramme: From enrollment to death of patients. Estimated about 1 year.
The length of time from enrollment until the time of death (OS, overall survival)
From enrollment to death of patients. Estimated about 1 year.
Incidence of treatment-related adverse events
Tidsramme: Time Frame: 0 to 1 year
The incidence of treatment-related adverse events were graded with the use of the National Cancer Institute Common Terminology Criteria for Adverse Events, version 4.0.
Time Frame: 0 to 1 year

Samarbejdspartnere og efterforskere

Det er her, du vil finde personer og organisationer, der er involveret i denne undersøgelse.

Datoer for undersøgelser

Disse datoer sporer fremskridtene for indsendelser af undersøgelsesrekord og resumeresultater til ClinicalTrials.gov. Studieregistreringer og rapporterede resultater gennemgås af National Library of Medicine (NLM) for at sikre, at de opfylder specifikke kvalitetskontrolstandarder, før de offentliggøres på den offentlige hjemmeside.

Studer store datoer

Studiestart (Faktiske)

1. januar 2018

Primær færdiggørelse (Forventet)

1. januar 2025

Studieafslutning (Forventet)

1. juni 2025

Datoer for studieregistrering

Først indsendt

31. december 2019

Først indsendt, der opfyldte QC-kriterier

31. december 2019

Først opslået (Faktiske)

2. januar 2020

Opdateringer af undersøgelsesjournaler

Sidste opdatering sendt (Faktiske)

8. februar 2021

Sidste opdatering indsendt, der opfyldte kvalitetskontrolkriterier

5. februar 2021

Sidst verificeret

1. februar 2021

Mere information

Begreber relateret til denne undersøgelse

Plan for individuelle deltagerdata (IPD)

Planlægger du at dele individuelle deltagerdata (IPD)?

UBESLUTET

IPD-planbeskrivelse

Undecided

Lægemiddel- og udstyrsoplysninger, undersøgelsesdokumenter

Studerer et amerikansk FDA-reguleret lægemiddelprodukt

Ja

Studerer et amerikansk FDA-reguleret enhedsprodukt

Ingen

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Kliniske forsøg med Tilbagevendende gliom

Kliniske forsøg med Apatinib

Abonner